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Ischemic vaso-occlusive retinopathy as an initial manifestation is rare in pediatric systemic lupus erythematosus (pSLE). A 13-year-old girl presented with two months’ history of papules and crusts with fatigue, weight loss, and abrupt hair loss. Pancytopenia and findings compatible with SLE, including positive direct Coombs’ test, antinuclear antibody (Ab), anti-double stranded DNA Ab, anti-Smith Ab, anti-ribonucleoprotein Ab, lupus anticoagulant, anti-β2 glycoprotein Immunoglobulin G, and anti-cardiolipin Ab, were detected. Bi-nasal hemianopsia was detected. Initial visual acuity was hand motion in the right eye and 15/20 in the left. Fundoscopy showed massive exudation around the optic disc with macular edema, vascular sheathing with perivascular hemorrhage in the whole retina, and ghost vessels in the peripheral retina. Intravitreal triamcinolone injection and dexamethasone implant injection were administered. Visual symptoms improved but did not recover. Methylprednisolone therapy and photocoagulation improved visual acuity and fever. Early intervention for retinopathy in pSLE can help prevent vision-loss.
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Background@#and Purpose Ischemic stroke recurs despite the use of antiplatelet agents. Various mechanisms are involved in recurrence due to intracranial atherosclerosis (ICAS) and extracranial atherosclerosis (ECAS). High-on-aspirin platelet reactivity (HAPR) may differ between recurrent stroke due to ICAS and ECAS. @*Methods@#Patients with recurrent ischemic stroke as a result of large-artery atherosclerosis despite taking aspirin were enrolled consecutively. Ischemic stroke was classified as stroke due to ICAS or ECAS according to the location of the culprit stenosis. An aspirin reaction units (ARU) value of >550 IU was defined as HAPR. HAPR and its associated factors were compared between the two groups and also considering the mechanism of stroke. @*Results@#Among the 190 patients with recurrent stroke (111 with ICAS and 79 with ECAS), 36 (18.3%) showed HAPR. The ARU value was higher in the ECAS than the ICAS group (492± 83 vs. 465±78, mean±standard deviation; p=0.028), as was the proportion of patients with HAPR (27.8% vs. 12.6%, p=0.008). Being male and having stroke due to ECAS (reference = stroke due to ICAS: odds ratio=5.760; 95% confidence interval=2.154–15.403; p<0.001) was independently associated with HAPR. The ARU value differed according to the stroke mechanism, and was highest in those with artery-to-artery embolism. Artery-to-artery embolism was independently associated with HAPR in both the ICAS and ECAS groups. @*Conclusions@#Recurrent stroke due to ECAS was more strongly associated with HAPR and insufficient antiplatelet inhibition than was that due to ICAS. Artery-to-artery embolism was associated with HAPR in recurrent ischemic stroke as a result of ICAS or ECAS.
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X-linked inhibitor of apoptosis protein (XIAP) deficiency is a rare immunodeficiency disorder. A 13-month-old boy was diagnosed with pure red cell aplasia (PRCA) and treated with steroid and cyclosporine. Bone marrow showed diminished erythroid precursors, and positive results for Parvovirus B19 and Cytomegalovirus (CMV) infection. A genetic study of Diamond-Blackfan anemia was negative. Five months later, he was admitted due to fever and lymphadenopathy. PCR showed still positive for the Parvovirus, CMV, and Epstein-Barr virus (EBV). He was diagnosed with diffuse large B-cell lymphoma that was positive for EBV. The patient received chemotherapy with R-CHOP, and achieved complete remission. Immunoglobulin (Ig) levels were within an age-matched normal range until the completion of chemotherapy. Subsequently, he was admitted nine times due to recurrent pneumonia and acute otitis media between two and eight years old. We reanalyzed the Ig levels and lymphocyte subsets: IgG, IgA, and IgM were 30 mg/dL, below 1.0 mg/dL, and 36 mg/dL, respectively. Lymphocyte subsets showed nearly absent CD19 (+) cells, but T- and NK cell counts were within normal ranges. A genetic study showed a hemizygous inframe deletion mutation in exon 4 of the IAP gene without the SH2D1A mutation, consistent with a XIAP deficiency. Therefore, he was diagnosed with XIAP deficiency. Genetic analysis of his mother, aunt and elder sister showed that they were carriers of the same gene mutation. He receives intravenous Ig regularly with follow-up, and still requires a low dose steroid to maintain hemoglobin level. We report XIAP deficiency as initial presentation of PRCA.
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Background and Objectives@#Prior studies have shown that stroke patients treated with percutaneous left atrial appendage occlusion (LAAO) for non-valvular atrial fibrillation (NVAF) experience better outcomes than similar patients treated with warfarin. We investigated the impact of percutaneous left atrial appendage closure on post-stroke neurological outcomes in NVAF patients, compared with non-vitamin K antagonist oral anticoagulant (NOAC) therapy. @*Methods@#Medical records for 1,427 patients in multiple registries and for 1,792 consecutive patients at 6 Korean hospitals were reviewed with respect to LAAO or NOAC treatment.Stroke severity in patients who experienced ischemic stroke or transient ischemic attack after either treatment was assessed with modified Rankin Scale (mRS) scoring at hospital discharge and at 3 and 12 months post-stroke. @*Results@#mRS scores were significantly lower in LAAO patients at 3 (p<0.01) and 12 months (p<0.01) post-stroke, despite no significant differences in scores before the ischemic cerebrovascular event (p=0.22). The occurrences of disabling ischemic stroke in the LAAO and NOAC groups were 36.7% and 44.2% at discharge (p=0.47), 23.3% and 44.2% at 3 months post-stroke (p=0.04), and 13.3% and 43.0% at 12 months post-stroke (p=0.01), respectively.Recovery rates for disabling ischemic stroke at discharge to 12 months post-stroke were significantly higher for LAAO patients (50.0%) than for NOAC patients (5.6%) (p<0.01). @*Conclusions@#Percutaneous LAAO was associated with more favorable neurological outcomes after ischemic cerebrovascular event than NOAC treatment.
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Background@#and Purpose We aimed to develop a model predicting early recanalization after intravenous tissue plasminogen activator (t-PA) treatment in large-vessel occlusion. @*Methods@#Using data from two different multicenter prospective cohorts, we determined the factors associated with early recanalization immediately after t-PA in stroke patients with large-vessel occlusion, and developed and validated a prediction model for early recanalization. Clot volume was semiautomatically measured on thin-section computed tomography using software, and the degree of collaterals was determined using the Tan score. Follow-up angiographic studies were performed immediately after t-PA treatment to assess early recanalization. @*Results@#Early recanalization, assessed 61.0±44.7 minutes after t-PA bolus, was achieved in 15.5% (15/97) in the derivation cohort and in 10.5% (8/76) in the validation cohort. Clot volume (odds ratio [OR], 0.979; 95% confidence interval [CI], 0.961 to 0.997; P=0.020) and good collaterals (OR, 6.129; 95% CI, 1.592 to 23.594; P=0.008) were significant factors associated with early recanalization. The area under the curve (AUC) of the model including clot volume was 0.819 (95% CI, 0.720 to 0.917) and 0.842 (95% CI, 0.746 to 0.938) in the derivation and validation cohorts, respectively. The AUC improved when good collaterals were added (derivation cohort: AUC, 0.876; 95% CI, 0.802 to 0.950; P=0.164; validation cohort: AUC, 0.949; 95% CI, 0.886 to 1.000; P=0.036). The integrated discrimination improvement also showed significantly improved prediction (0.097; 95% CI, 0.009 to 0.185; P=0.032). @*Conclusions@#The model using clot volume and collaterals predicted early recanalization after intravenous t-PA and had a high performance. This model may aid in determining the recanalization treatment strategy in stroke patients with large-vessel occlusion.
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Background and Objectives@#Prior studies have shown that stroke patients treated with percutaneous left atrial appendage occlusion (LAAO) for non-valvular atrial fibrillation (NVAF) experience better outcomes than similar patients treated with warfarin. We investigated the impact of percutaneous left atrial appendage closure on post-stroke neurological outcomes in NVAF patients, compared with non-vitamin K antagonist oral anticoagulant (NOAC) therapy. @*Methods@#Medical records for 1,427 patients in multiple registries and for 1,792 consecutive patients at 6 Korean hospitals were reviewed with respect to LAAO or NOAC treatment.Stroke severity in patients who experienced ischemic stroke or transient ischemic attack after either treatment was assessed with modified Rankin Scale (mRS) scoring at hospital discharge and at 3 and 12 months post-stroke. @*Results@#mRS scores were significantly lower in LAAO patients at 3 (p<0.01) and 12 months (p<0.01) post-stroke, despite no significant differences in scores before the ischemic cerebrovascular event (p=0.22). The occurrences of disabling ischemic stroke in the LAAO and NOAC groups were 36.7% and 44.2% at discharge (p=0.47), 23.3% and 44.2% at 3 months post-stroke (p=0.04), and 13.3% and 43.0% at 12 months post-stroke (p=0.01), respectively.Recovery rates for disabling ischemic stroke at discharge to 12 months post-stroke were significantly higher for LAAO patients (50.0%) than for NOAC patients (5.6%) (p<0.01). @*Conclusions@#Percutaneous LAAO was associated with more favorable neurological outcomes after ischemic cerebrovascular event than NOAC treatment.
ABSTRACT
Background@#and Purpose We aimed to develop a model predicting early recanalization after intravenous tissue plasminogen activator (t-PA) treatment in large-vessel occlusion. @*Methods@#Using data from two different multicenter prospective cohorts, we determined the factors associated with early recanalization immediately after t-PA in stroke patients with large-vessel occlusion, and developed and validated a prediction model for early recanalization. Clot volume was semiautomatically measured on thin-section computed tomography using software, and the degree of collaterals was determined using the Tan score. Follow-up angiographic studies were performed immediately after t-PA treatment to assess early recanalization. @*Results@#Early recanalization, assessed 61.0±44.7 minutes after t-PA bolus, was achieved in 15.5% (15/97) in the derivation cohort and in 10.5% (8/76) in the validation cohort. Clot volume (odds ratio [OR], 0.979; 95% confidence interval [CI], 0.961 to 0.997; P=0.020) and good collaterals (OR, 6.129; 95% CI, 1.592 to 23.594; P=0.008) were significant factors associated with early recanalization. The area under the curve (AUC) of the model including clot volume was 0.819 (95% CI, 0.720 to 0.917) and 0.842 (95% CI, 0.746 to 0.938) in the derivation and validation cohorts, respectively. The AUC improved when good collaterals were added (derivation cohort: AUC, 0.876; 95% CI, 0.802 to 0.950; P=0.164; validation cohort: AUC, 0.949; 95% CI, 0.886 to 1.000; P=0.036). The integrated discrimination improvement also showed significantly improved prediction (0.097; 95% CI, 0.009 to 0.185; P=0.032). @*Conclusions@#The model using clot volume and collaterals predicted early recanalization after intravenous t-PA and had a high performance. This model may aid in determining the recanalization treatment strategy in stroke patients with large-vessel occlusion.
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Being born small for gestational age (SGA) has been strongly associated with mortality during the perinatal period and long-term risk of metabolic syndrome, including type 2 diabetes mellitus, hypertension, hyperlipidemia, and coronary heart disease. Insulin resistance is an important factor in the development of metabolic syndrome in SGA, with several proposed hypotheses. Here, we report two cases of non-obese adolescent patients with early onset type 2 diabetes who were born SGA. Of these, one experienced catch-up growth, while the other did not. Both had a high body fat percentage at the time of diagnosis of type 2 diabetes and were diagnosed with fatty liver and hyperlipidemia before adolescence, at the age of 7 years. Early interventions for SGA are needed for healthy catch-up growth to prevent metabolic diseases in the future.
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Being born small for gestational age (SGA) has been strongly associated with mortality during the perinatal period and long-term risk of metabolic syndrome, including type 2 diabetes mellitus, hypertension, hyperlipidemia, and coronary heart disease. Insulin resistance is an important factor in the development of metabolic syndrome in SGA, with several proposed hypotheses. Here, we report two cases of non-obese adolescent patients with early onset type 2 diabetes who were born SGA. Of these, one experienced catch-up growth, while the other did not. Both had a high body fat percentage at the time of diagnosis of type 2 diabetes and were diagnosed with fatty liver and hyperlipidemia before adolescence, at the age of 7 years. Early interventions for SGA are needed for healthy catch-up growth to prevent metabolic diseases in the future.
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A carpal coalition that indicates the fusion of two carpal bones resulting from the failure of differentiation is a rare condition compared to the tarsal coalition. The most common carpal coalition is the luno-triquetral coalition, followed by the capitate-hamate coalition. Most of these coalitions are usually asymptomatic. Thus far, only a few cases of a coalition between the scaphoid and lunate with accompanied anomalies in the ipsilateral hand, such as accessory carpal bone or ray deficiency, have been reported. We present, for the first time, a case of a symptomatic isolated scapho-lunate coalition without any accompanying anomalies.
Subject(s)
Carpal Bones , HandABSTRACT
PURPOSE: The Alberta Stroke Program Early CT Score (ASPECTS) was devised to quantify the extent of early ischemic changes in the middle cerebral artery territory on brain CT. We performed a systematic review and meta-analysis of studies that presented clinical outcomes and baseline ASPECTS in ischemic stroke patients managed with endovascular methods to validate the use of ASPECTS for risk prognostication. MATERIALS AND METHODS: We searched the MEDLINE, EMBASE, and Cochran databases for observational or interventional studies that reported clinical outcomes and baseline ASPECTS in ischemic stroke patients treated with endovascular methods. Data were pooled to perform a meta-analysis for comparisons of clinical outcomes between high and low ASPECTS patients. RESULTS: A meta-analysis of 13 studies (six observational and seven interventional) revealed favorable outcomes (mRS sore 0-2 at 90 days) for high baseline ASPECTS (odds ratio=2.22; 95% CI: 1.74-2.86). CONCLUSION: High ASPECTS is a predictor of favorable outcome after endovascular therapy for ischemic stroke.
Subject(s)
Humans , Alberta , Brain , Middle Cerebral Artery , Stroke , ThrombectomyABSTRACT
BACKGROUND AND PURPOSE: To compare the efficacy and safety of antiplatelet agents for the secondary prevention of ischemic stroke based on cytochrome P450 2C19 (CYP2C19) polymorphisms. METHODS: This study was a prospective, multicenter, randomized, parallel-group, open-label, blind genotype trial. First time non-cardiogenic ischemic stroke patients were enrolled and screened within 30 days. Participants were randomized to receive either triflusal or clopidogrel for secondary stroke prevention. The primary outcome was the time from randomization to first recurrent ischemic stroke or hemorrhagic stroke. RESULTS: The required sample size was 1,080 but only 784 (73%) participants were recruited. In patients with a poor CYP2C19 genotype for clopidogrel metabolism (n=484), the risk of recurrent stroke among those who received triflusal treatment was 2.9% per year, which was not significantly different from those who received clopidogrel treatment (2.2% per year; hazard ratio [HR], 1.23; 95% confidence interval [CI], 0.60–2.53). In the clopidogrel treatment group (n=393), 38% had good genotypes and 62% poor genotypes for clopidogrel metabolism. The risk of recurrent stroke in patients with a good CYP2C19 genotype was 1.6% per year, which was not significantly different from those with a poor genotype (2.2% per year; HR, 0.69; 95% CI, 0.26–1.79). CONCLUSIONS: Whilst there were no significant differences between the treatment groups in the rates of stroke recurrence, major vascular events, or coronary revascularization, the efficacy of antiplatelet agents for the secondary prevention of stroke according to CYP2C19 genotype status remains unclear.
Subject(s)
Humans , Cytochrome P-450 CYP2C19 , Cytochrome P-450 Enzyme System , Cytochromes , Genotype , Metabolism , Platelet Aggregation Inhibitors , Prospective Studies , Random Allocation , Recurrence , Sample Size , Secondary Prevention , StrokeABSTRACT
PURPOSE: Although asymptomatic coronary artery occlusive disease is common in stroke patients, the long-term advantages of undergoing evaluation for coronary arterial disease using multi-detector coronary computed tomography (MDCT) have not been well established in stroke patients. We compared long-term cardio-cerebrovascular outcomes between patients who underwent MDCT and those who did not. MATERIALS AND METHODS: This was a retrospective study in a prospective cohort of consecutive ischemic stroke patients. Of the 3117 patients who were registered between July 2006 and December 2012, MDCT was performed in 1842 patients [MDCT (+) group] and not in 1275 patients [MDCT (−) group]. Occurrences of death, cardiovascular events, and recurrent stroke were compared between the groups using Cox proportional hazards models and propensity score analyses. RESULTS: During the mean follow-up of 38.0±24.8 months, 486 (15.6%) patients died, recurrent stroke occurred in 297 (9.5%), and cardiovascular events occurred in 60 patients (1.9%). Mean annual risks of death (9.34% vs. 2.47%), cardiovascular events (1.2% vs. 0.29%), and recurrent stroke (4.7% vs. 2.56%) were higher in the MDCT (−) group than in the MDCT (+) group. The Cox proportional hazards model and the five propensity score-adjusted models consistently demonstrated that the MDCT (−) group was at a high risk of cardiovascular events (hazard ratios 3.200, 95% confidence interval 1.172–8.735 in 1:1 propensity matching analysis) as well as death. The MDCT (−) group seemed to also have a higher risk of recurrent stroke. CONCLUSION: Acute stroke patients who underwent MDCT experienced fewer deaths, cardiovascular events, and recurrent strokes during follow-up.
Subject(s)
Female , Humans , Male , Asymptomatic Diseases , Coronary Artery Disease/diagnostic imaging , Follow-Up Studies , Multidetector Computed Tomography/statistics & numerical data , Propensity Score , Proportional Hazards Models , Prospective Studies , Recurrence , Retrospective Studies , Risk Assessment , Risk Factors , Stroke/complicationsABSTRACT
BACKGROUND: The study aimed to determine the type of capsular insertion and the extent of capsular elongation in anterior shoulder instability by quantitatively evaluating their computed tomography arthrographic (CTA) findings, and to investigate the correlation of these parameters with surgical outcomes. METHODS: We retrospectively reviewed 71 patients who underwent CTA and arthroscopic capsulolabral reconstruction for anterior shoulder instability between April 2004 and August 2008. The control group comprised 72 patients diagnosed as isolated type II superior labrum anterior to posterior (SLAP) lesion during the period. Among the 143 patients, 71 were examined with follow-up CTA at an average 13.8 months after surgery. It was measured the capsular length and cross-sectional area at two distinct capsular regions: the 4 and 5 o'clock position of the capsule. RESULTS: With regards to the incidence of the type of anterior capsular insertion, type I was more common in the control group, whereas type III more common than in the instability group. Anterior capsular length and cross-sectional area were significantly greater in the instability group than in the control group. Among patients of the instability group, the number of dislocations and the presence of anterior labroligamentous periosteal sleeve avulsion lesion were significantly associated with anterior capsular redundancy. Postoperatively, recurrence was found in 3 patients (4.2%) and their postoperative capsular length and cross-sectional area were greater than those of patients without recurrence. CONCLUSIONS: Capsular insertion type and capsular redundancy derived through CTA may serve as important parameters for the management of anterior shoulder instability.
Subject(s)
Humans , Arthrography , Joint Dislocations , Follow-Up Studies , Incidence , Joint Instability , Recurrence , Retrospective Studies , ShoulderABSTRACT
BACKGROUND: The study aimed to determine the type of capsular insertion and the extent of capsular elongation in anterior shoulder instability by quantitatively evaluating their computed tomography arthrographic (CTA) findings, and to investigate the correlation of these parameters with surgical outcomes. METHODS: We retrospectively reviewed 71 patients who underwent CTA and arthroscopic capsulolabral reconstruction for anterior shoulder instability between April 2004 and August 2008. The control group comprised 72 patients diagnosed as isolated type II superior labrum anterior to posterior (SLAP) lesion during the period. Among the 143 patients, 71 were examined with follow-up CTA at an average 13.8 months after surgery. It was measured the capsular length and cross-sectional area at two distinct capsular regions: the 4 and 5 o'clock position of the capsule. RESULTS: With regards to the incidence of the type of anterior capsular insertion, type I was more common in the control group, whereas type III more common than in the instability group. Anterior capsular length and cross-sectional area were significantly greater in the instability group than in the control group. Among patients of the instability group, the number of dislocations and the presence of anterior labroligamentous periosteal sleeve avulsion lesion were significantly associated with anterior capsular redundancy. Postoperatively, recurrence was found in 3 patients (4.2%) and their postoperative capsular length and cross-sectional area were greater than those of patients without recurrence. CONCLUSIONS: Capsular insertion type and capsular redundancy derived through CTA may serve as important parameters for the management of anterior shoulder instability.
Subject(s)
Humans , Arthrography , Joint Dislocations , Follow-Up Studies , Incidence , Joint Instability , Recurrence , Retrospective Studies , ShoulderABSTRACT
PURPOSE: In this study, we investigated the stroke mechanism and the factors associated with ischemic stroke in patients with nonvalvular atrial fibrillation (NVAF) who were on optimal oral anticoagulation with warfarin. MATERIALS AND METHODS: This was a multicenter case-control study. The cases were consecutive patients with NVAF who developed cerebral infarction or transient ischemic attack (TIA) while on warfarin therapy with an international normalized ratio (INR) > or =2 between January 2007 and December 2011. The controls were patients with NVAF without ischemic stroke who were on warfarin therapy for more than 1 year with a mean INR > or =2 during the same time period. We also determined etiologic mechanisms of stroke in cases. RESULTS: Among 3569 consecutive patients with cerebral infarction or TIA who had NVAF, 55 (1.5%) patients had INR > or =2 at admission. The most common stroke mechanism was cardioembolism (76.0%). Multivariate analysis demonstrated that smoking and history of previous ischemic stroke were independently associated with cases. High CHADS2 score (> or =3) or CHA2DS2-VASc score (> or =5), in particular, with previous ischemic stroke along with > or =1 point of other components of CHADS2 score or > or =3 points of other components of CHA2DS2-VASc score was a significant predictor for development of ischemic stroke. CONCLUSION: NVAF patients with high CHADS2/CHA2DS2-VASc scores and a previous ischemic stroke or smoking history are at high risk of stroke despite optimal warfarin treatment. Some other measures to reduce the risk of stroke would be necessary in those specific groups of patients.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anticoagulants/adverse effects , Atrial Fibrillation/complications , Cardiovascular Diseases , Case-Control Studies , Cerebral Infarction/complications , Multivariate Analysis , Risk Factors , Stroke/etiology , Warfarin/adverse effectsABSTRACT
PURPOSE: In this study, we investigated the stroke mechanism and the factors associated with ischemic stroke in patients with nonvalvular atrial fibrillation (NVAF) who were on optimal oral anticoagulation with warfarin. MATERIALS AND METHODS: This was a multicenter case-control study. The cases were consecutive patients with NVAF who developed cerebral infarction or transient ischemic attack (TIA) while on warfarin therapy with an international normalized ratio (INR) > or =2 between January 2007 and December 2011. The controls were patients with NVAF without ischemic stroke who were on warfarin therapy for more than 1 year with a mean INR > or =2 during the same time period. We also determined etiologic mechanisms of stroke in cases. RESULTS: Among 3569 consecutive patients with cerebral infarction or TIA who had NVAF, 55 (1.5%) patients had INR > or =2 at admission. The most common stroke mechanism was cardioembolism (76.0%). Multivariate analysis demonstrated that smoking and history of previous ischemic stroke were independently associated with cases. High CHADS2 score (> or =3) or CHA2DS2-VASc score (> or =5), in particular, with previous ischemic stroke along with > or =1 point of other components of CHADS2 score or > or =3 points of other components of CHA2DS2-VASc score was a significant predictor for development of ischemic stroke. CONCLUSION: NVAF patients with high CHADS2/CHA2DS2-VASc scores and a previous ischemic stroke or smoking history are at high risk of stroke despite optimal warfarin treatment. Some other measures to reduce the risk of stroke would be necessary in those specific groups of patients.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anticoagulants/adverse effects , Atrial Fibrillation/complications , Cardiovascular Diseases , Case-Control Studies , Cerebral Infarction/complications , Multivariate Analysis , Risk Factors , Stroke/etiology , Warfarin/adverse effectsABSTRACT
OBJECTIVES: Obstructive sleep apnea-hypopnea syndrome (OSAHS) and insomnia are two of the most common sleep disorders in the general population. Because OSAHS patients with insomnia may have difficulty in adapting to the sleep breathing medical equipment, it is necessary to pay special attention to the diagnosis and treatment of comorbid insomnia. This study is to investigate the emotion and personality in OSAHS patients with insomnia complaints by using Minnesota Multiphasic Personality Inventory-2 (MMPI-2). METHODS: We reviewed the results of the standardized questionnaires assessing sleep-related variables, MMPI, and polysomnographic findings of the patients diagnosed as OSAHS. RESULTS: 145 subjects were 49.05+/-11.83 years of age. The mean Respiratory Disturbance Index was 33.57+/-19.91 and the mean score of Insomnia Severity Index (ISI) was 11.52+/-6.49. The mean scores of the Beck Depression Inventory (BDI) and MMPI-2 were within normal ranges. We divided the patients into two groups based on the scores of the ISI, OSAHS with insomnia (n=109) and OSAHS without insomnia (n=36). OSAHS patients with insomnia symptoms had significantly higher scores of hypochondriasis, hysteria, psychasthenia, schizophrenia, paranoia and psychopathic deviate scales and BDI than those without insomnia. CONCLUSIONS: Our results suggest that insomnia complaints are very common in OSAHS patients and the psychological problems are more frequently found in OSAHS patients with insomnia symptom than those without it.
Subject(s)
Humans , Depression , Diagnosis , Hypochondriasis , Hysteria , Minnesota , MMPI , Paranoid Disorders , Polysomnography , Reference Values , Respiration , Schizophrenia , Sleep Apnea, Obstructive , Sleep Wake Disorders , Sleep Initiation and Maintenance Disorders , Weights and MeasuresABSTRACT
No abstract available.